Qualitative Methods Section - From Frost, D., Hammack, P., Wilson, B., Russell, S., Lightfoot, M., & Meyer, I. Understanding sexual identity development and minority stress in the context of social change: A qualitative approach. Unpublished Manuscript.

The Generations Study

The Generations study explores how cohort and age impact sexual identity, minority stress and resilience, access to health care, and health outcomes.  The study focused on three cohorts of sexual minorities in the U.S.  The three cohorts were defined by the experiences during adolescence and emerging adulthood that corresponded with three very different social environments: We referred to them as the “cultural inclusion” generations, young sexual minorities (18 − 25 at the beginning of the study in 2015), the generation of institutional advancement (ages 34 – 41 years old) and the pride generation (ages 52 – 59).  The “identity formation” generations came of age as the first post-stonewall generations, when homosexuality was considered a mental disorder and sodomy was illegal in many states but when the first gay pride event took place (in 1970) and gay pride discourse took hold in the LGBT community. The second generation came of age at a time when the HIV/AIDS epidemic was at its height but effective AIDS treatments became available.  This generation was also the first to have great access to resources through the internet.  LGBT people gained heightened public scrutiny and increase of stigma and prejudice due to fear of AIDS but also greater political awareness and consolidation of LGBT community institutions (like health centers).  Representing improved social context, the equality generation came of age after sodomy laws were ruled unconstitutional, when discourse shifted to that of equality, leading to inclusion of sexual minorities in the military, and equal access to legal marriage.

The qualitative component of the Generations Study sought to address the following specific aims:

1. To describe similarities and differences between younger and older sexual minority cohorts in trajectories of the formation, expression, and experience of sexual identity.

2. To describe similarities and differences between members of younger and older sexual minority cohorts in trajectories of exposure to minority stress and resilience (availability of coping and social support resources).

3. To describe similarities and differences among sexual minority cohorts in trajectories of utilization of health and social services and public health information.

A Qualitative Approach

To study these questions, we combined elements of narrative and phenomenological approaches (e.g., Frost, McClelland, Clark, & Boylan, 2014).  This required a semi-structured interview protocol that was open enough to provide storied accounts of lived experience reflective of narrative meaning making processes as well as specific content-oriented questions about phenomena central to the aims and research questions of the study (e.g., sex and sexual cultures, community, stress and coping).  Thus, the instrument included general questions about key events and trajectories in participants’ general life stories, as well as specific questions about same-sex awareness and experiences and sexual identity development, minority stress experiences, including stressful life events related to sexuality, experiences with stigma and expectations of discrimination based on sexuality, internalized homophobia, and perceptions of relationships between sexual minority stress and the structural and cultural dimensions of other social statuses (e.g., race/ethnicity, gender, rural residence).  Given the focus of the study on identity development and individual-level meaning making of experiences of minority stress, the design of the study involved individual one-on-one interviews, rather than focus groups. 

Sampling

Sampling was central to achieving the aims of the study related to foundations in minority stress, life course, and intersectionality frameworks. Many qualitative studies focus on one geographic area and lack the ability to compare across locations, potentially missing important diversity in the lived experiences of sexual minorities.  To address this, we recruited participants from four geographic regions of the country: New York City Metro area, San Francisco Bay area, Tucson, Arizona area, and Austin, Texas area.  Each site had a catchment area of 80 miles, which included urban and non-urban areas. A total number of 191 interviews were conducted across the sites (see Table 1). Participants were eligible if they (a) were cisgender or genderqueer men or women; (b) identified as gay, lesbian, or bisexual (but they can use other terms to refer to their non-heterosexual sexual orientation, such as “homosexual,” “queer,” “same-gender loving,” etc.); (c) were ages 18 – 25, 34 – 41, or 52 - 59; (d) identified as Asian, non-Hispanic Black or African American, Native American, non-Hispanic White or Caucasian, or Hispanic/Latino (again, they may use other terms to refer to these racial/ethnic identities, such as “Mexican-American”); (e) resided in the U.S. between the ages of 6-13 (to assure these individuals came of age in the social contexts that are the subject of this investigation); (f) were proficient English; (g) completed 6 grades of education or more, and (h) resided within the target zip-codes in New York City, NY, Bay Area, CA, Austin, TX, and Tucson, AZ.

Based on the study’s foundations in intersectional and life course perspectives, we used quota sampling to ensure roughly equal representation of participants across these age cohort, gender, and racial/ethnic groups (Table 2).   

To achieve these sampling goals, the study employed a modified targeted nonprobability sampling strategy, using an ethnographic approach to identify key venues frequented by sexual minority individuals in each of the four sites (Meyer, Schwartz, & Frost, 2008; Waters & Biernacki, 1989). Venues included stores, cafes, and restaurants, churches/temples, parks and other outdoor areas (street), bars and clubs, etc. To minimize bias inherent to community samples, we avoided recruitment from venues that, by design, over-represent individuals with high levels of mental health problems and/or stressful life events (e.g., 12-step programs, HIV/AIDS service providers). To reach individuals who may not otherwise attend the physical venues, targeted study advertisements were placed in local social media. Trained research workers recruited individuals in these venues, providing study information including a study website and toll-free number where information and screening for eligibility was conducted. To avoid saturating the sample with attendees of any particular venue at a particular time, recruitment caps were used so that no venue was disproportionately represented in the sample. 

Interviews were conducted at university offices or another private location preferred by participants (e.g., home, library), at each of 4 interview sites: The San Francisco Bay Area, New York City metropolitan area; Tucson, Arizona, and Austin, Texas.  Interviews were conducted by trained interviewers, lasting roughly 120 – 180 minutes.  Participants received a $75 incentive for their participation. Data were collected between April, 2015 and April, 2016.